Objective To study the thyroid volume(TV) of patients with autoimmune thyroid disease (AITD) and the iodine intake and the factors associated with the goiter of patients with AITD.Methods Questionnaires,physical examination,urinary iodine concentration and thyroid B ultrasound were performed in cases of newly diagnosed patients with AITD.Result The TV of patients with AITD did not associated with the urinary iodine concentration (P ＞ 0.05).The TV associated with patients gender and age and goiter of palpation (P ＜ 0.05).Conclusion The U-shape relation did not show between iodine and goiter in patients with AITD.The goiter of patients with AITD did not associated with the iodine intake.

Objective Toinvestigate iodine nutrition,thyroid volume and function of children and women in high water iodine areas,and to discuss the cut-off point of water iodine level where should be defined as iodine excessive areas.Methods In iodine excessive townships in Xiaodian and Qingxu Counties of Taiyuan City,all villages were divided to 4 groups according to the concentration of iodine in drinking water:50 ～ ＜ 100 μg/L (Group A),100 ～ ＜ 150 μg/L(Group B),150 ～ ＜ 300 μg/L(Group C) and ≥300 μg/L(Group D),and 2-3 villages were randomly selected from each group as investigation sites.Two hundred children aged 8-10 and 60 women (20 pregnant women,20 breasffeeding women and 20 women of childbearing age,respectively) were sampled.Drinking water,edible salt and once random urine samples for each studying object were collected,and the iodine content was measured.The goiter volume of children aged 8-10 and triiodothyronine (FT3),free thyroxine (FT4),thyroid stimulating hormone (TSH) of women were determined.Results Totally 708 children and 236 women were selected as respondents who ate non-iodized salt.Iodine content in drinking water of children in groups A,B,C and D was 73.8,144.7,258.5 and 501.0 μg/L,respectively,and that of women was 73.8,144.7,242.7 and 485.9 μg/L,respectively.Median urinary iodine of children in groups A,B,C and D was 274.3,312.8,455.6 and 793.5 μg/L,respectively,and that of women was 238.3,235.2,371.6 and 641.6 μg/L,respectively.The median urinary iodine of children and women increased with increasing water content of iodine.The goiter rate of children was 5.6％ (11/196),13.2％ (25/189),12.6％ (20/158) and 10.9％ (18/165) for each group,respectively,which also increased with increasing water content of iodine.In groups A,C and D,the FT3 and FT4 levels[pmol/L:(3.70 ± 0.59),(14.01 ± 2.44); (3.43 ± 0.57),(12.87 ± 2.12); (3.42 ± 0.47),(12.66 ±1.78)] in pregnant woman were lower than those in breasffeeding women[pmol/L:(4.26 ± ±0.57),(14.73 ± 2.36;(4.28 ± 0.40),(14.77 ± 1.19); (4.36 ± 0.65),(15.66 ± 2.84)] and women of childbearing age[pmol/L:(4.80 ±0.50),(17.47 ± 2.11); (4.21 ± 0.48),(15.83 ± 1.64); (4.26 ± 0.52),(15.53 ± 1.81)].With increasing water content of iodine,FT4 level was decreasing and TSH level was increasing gradually in women.Conclusions When water iodine exceeds 100 μg/L,goiter rate of children has increased significantly.Iodine excessive women and children have appeared one after another with increasing water content of iodine.Women incidence of subclinical hypothyroidism risk has increased with increasing water content of iodine,and the detection rate of subclinical hypothyroidism is significantly higher when water iodine is higher than 300 μg/L.The cut-off point of iodine excessive areas should be descend from 150 μg/L to 100 μg/L.

Objective To evaluate the characteristics and treatment of ovary torsion after controlled ovarian hyperstimulation.Methods Between Jan.2008 and Dec.2011,5 cases with ovary torsion who underwent ovarian hyperstimulation were retrospectively studied.Results Five cases presented intermittent lower abdominal from I to 38 days after oocyte retrieval.Enlargement of ovary and decreased or absent venous and/or arterial flow were demonstrated by Doppler sonography.Two torsions at left side,two torsions at right side,and one on bilateral side were observed.Three cases give up embryo transplantation,2 cases were pregnant after surgical treatment.One case with partial torsion was successfully treated with simple conservative treatment.Two cases with complete torsion were performed adnexectomy by laparotomy.One case with complete torsion with early pregnancy was managed by laparoscopic adnexectomy.One case with chemical pregnancy was managed by laparoscopic detorsion for left side and excision for right side.Postoperative pathology of ovary tissue all confirmed haemorrhage and necrosis.Conclusions Ovary torsion might occur after controlled ovarian hyperstimulation.The early management on ovary torsion will be benefit for preserving ovarian function.

Objective:To investigate the iodine nutrition level of pregnant women in Shanxi Province, and to provide basis for guiding pregnant women to supplement iodine scientifically.Methods:From 2016 to 2018, 40, 80 and 118 counties were selected in Shanxi Province. In each county, 5 townships were selected according to the east, west, south, north and middle orientation, 20 pregnant women were selected from each township. Urine and salt samples of pregnant women were collected, and urinary iodine and salt iodine contents were determined, respectively.Results:From 2016 to 2018, 3 590, 7 907, and 11 750 salt samples were collected from pregnant women's homes. The medians salt iodine were 23.80, 23.70, 23.25 mg/kg, and the qualified iodized salt consumption rates were 91.06% (3 269/3 590), 90.06% (7 121/7 907), 92.21% (10 835/11 750), and the coverage rate of iodized salts were 97.72% (3 508/3 590), 97.00% (7 670/7 907), 98.53% (11 577/11 750), and the qualified rate of iodized salts was 93.19% (3 269/3 508), 92.84% (7 121/7 670), 93.59% (10 835/11 577), respectively. There were statistically significant differences in the median salt iodine and qualified iodized salt consumption rate among pregnant women in different years ( H = 99.915, χ 2 = 27.988, P < 0.05). Totally 3 902, 7 892 and 11 745 urine samples of pregnant women were tested, and the medians (quartiles) urinary iodine were 174.20 (114.00, 251.08), 180.70 (117.13, 258.58) and 179.40 (115.90, 249.00) μg/L, respectively. There was statistically significant difference in the median urinary iodine among pregnant women in different years ( H = 12.368, P < 0.05). From 2016 to 2018, counties with appropriate levels of iodine accounted for 70.00% (28/40), 73.75% (59/80) and 70.34% (83/118), respectively. The medians (quartiles) urinary iodine levels of pregnant women in the early, middle and late stages of pregnancy ( n = 2 225, 5 727, 3 793) in 2018 were 177.62 (117.28, 257.23), 178.21 (117.40, 248.40) and 172.70 (112.98, 245.70) μg/L, respectively, and there was statistical by significant difference in urinary iodine levels among pregnant women in different pregnancy periods ( H = 11.077, P < 0.05). Conclusions:From 2016 to 2018, the iodine nutrition level of pregnant women in Shanxi Province is generally in an appropriate state, iodine deficiency or more than appropriate still exists in some areas. We should continue to carry out monitoring work, and focus on strengthening health education for pregnant women, and guide them to supplement iodine scientifically and accurately.

Objective To investigate the distribution of endemic arsenism and to provide a scientific basis for control and prevention of the disease.Methods According to previous investigation,in the high-arsenic water areas,the arsenic diseased areas and the surrounding lands,35 counties were investigated.Water arsenic was screened in all the survey sites,villages with water arsenic exceeding the standard were quantitative surveyed of water arsenic and the disease conditions.Screening of arsenic content in drinking water was done by the method of half-quantitative fast reagent kit.Quantitative determination of arsenic in water was done by hydride generationatomic fluorescence spectrometry (HG-AFS).Patients of endemic arsenism were diagnosed by the Standard of Diagnosis for Endemic Arsenism (WS/T 211-2001).Identification of area was done by Definition and Division Standard for Endemic Arsenism (WS 277-2007).The data were analyzed using SPSS 13.0 for windows.Results Water arsenic of 151 villages in 15 counties among 1 771 villages were higher than the national drinking water quality level(0.05 mg/L).Exposure population of high arsenic was 177 018 people.The census results of high arsenic water sources indicated that the ratio of drinking water arsenic levels higher than the national standard was 35.10％ (2 355/6 709) and the highest contents of arsenic was 1.733 0 mg/L.The disease census indicated that there were 33 latency arsenism districts and 118 arsenism districts.There was totally 39 757 patients with latency arsenism.Totally 137 261 people lived in arsenism districts.Light,moderate and severe arsenism districts was 82,29 and 7,respectively.Totally 1 244 suspicious patients with endemic arsenism were discovered,and 3 473 light and more severe patients were discovered and the detected rate of light and more severe patients was 2.54％ (3 473/136 924).Most patient were not serious.Conclusions High arsenic areas and endemic arsenism areas are distributed in 15 counties of Shanxi Province.In the future primary task in prevention and control of endemic arsenism is comprehensive prevention and control measures.

Objective To investigate resident iodine nutrition level in waterborne high iodine areas and prevalence of high iodine goiter in Shanxi Province.Methods In 2014,in Shanxi Province,in all the 10 high iodine counties (cities,districts),the jurisdiction area of each county (city,district) was divided into two blocks,high iodine and not high iodine districts,and in high iodine area of each county (city,area) according to their sub-area positions of east,south,west,north and center,a township was randomly selected (if the number of high iodine area in iodine excessive township ≤5,all townships were selected);four administrative villages in each monitoring township were randomly selected;in each administrative village,the edible salt samples of 15 randomly selected households were collected for detection of iodine content.Five counties (cities,districts) were selected from the province's 10 high iodine counties (cities,districts),water iodine content of 3 counties (cities,districts) was 150-300 μg/L,and 2 were ＞ 300 μg/L,one administrative village was selected from each county (city,area),household drinking water samples were collected to detect iodine content;and 100 elementary school children aged 8-10 were selected from the village where the monitoring stations located in for thyroid volume ultrasound measurement,and 30 of them were randomly selected for urinary iodine content detection.Results ① In the 10 high iodine counties (cities,districts),1 680 households salt samples were detected,and the rate of no iodine salt samples was 89.2％(1 499/1 680).② Fourteen water samples were collected in 5 counties (cities,districts),and the water iodine content was 155.7-467.3 μg/L.③ In the five high iodine counties (cities,districts),197 urine samples were collected from children aged 8 to 10.The median of urinary iodine was 466.5 μg/L;the median urinary iodine was 650.1 μg/L in water iodine≥300 μg/L children group which was significantly higher than that of the group with 150-300 μg/L water iodine content 332.5 μg/L (Z =-6.164,P ＜ 0.05);urinary iodine level of children and the water iodine of the corresponding village was positively correlated (r =0.543,P ＜ 0.05).④ In the five high iodine counties (cities,districts),543 children aged 8-10 were measured with their thyroid volume,the thyroid goiter rate was 6.8％(37/543);the goiter rate of water iodine ≥300 μg/L children group was [9.0％(28/311)] which was significantly higher than that in the iodine content of drinking water 150-300 μg/L group [3.9％(9/232),x2 =5.494,P ＜ 0.05].Conclusion The measurement of stopping iodized salt supply in high iodine areas in Shanxi Province is well implemented,iodine nutrition level and thyroid goiter rate in those areas are still too high,high iodine intervention measures can be focused on changing of the drinking water.

Objective To investigate the nutritional status of iodine among residents and the goiter disease of children in high water iodine areas in Shanxi Province,and to provide a scientific basis for establishment of longlasting control strategies and measures.Methods In 2012,according to the historical monitoring data,in the 10 high water iodine counties (citys,districts),one town was selected based on its location (east,west,south,north and middle) in each county (citie,district).In county (city,district) with 5 townships or less,all townships were selected.Four villages were selected in each township and fifteen residents in each village were selected to test salt iodine level.In five high water iodine counties (city,district),one or two high water iodine villages were selected,water samples were collected and the iodine content was measured; one hundred students aged 8-10 years old were chosen to examine their thyroid size.Thirty children were chosen from above students to collect their urine samples and to determine the iodine content.Results In 10 high water iodine counties (citys,districts),1 680 salt samples were tested.The rate of non-iodized salt was 85.2％ (1 432/1 680); in six villages of five high water iodine counties (citys,districts),the median of urinary iodine of 256 children aged 8 to 10 was 487.2 μg/L; in three villages which had improved the quality of water,the median of urinary iodine was 271.0 μg/L; other three villages which had not improved the quality of water,the median of urinary iodine was 692.6 μg/L.In those villages which had not improved the quality of water,urinary iodine of children ≥300 μg/L accounted for 85.8％ (139/162); in those villages which had improved the quality of water,high urinary iodine of children accounted for 41.5％ (39/94),and the difference was statistically significant (x2 =53.06,P ＜ 0.05).The thyroid was investigated among 591 children aged 8-10 years old,and the goiter rate was 6.6％(39/591).In those villages which had improved the quality of water,the goiter rate of children was 3.8％ (11/291),but in villages which had not improved the quality of water,the goiter rate of children was 9.3％ (28/300),and the difference was statistically significant (x2 =6.52,P ＜ 0.05).Conclusion The iodine nutrition level of residents in high water iodine areas in Shanxi is excessive,children's goiter disease has not been effectively controlled; water improvement to reduce iodine is the basic way to control the disease of high iodine.

Objective To analyze the effect of adjustments of control strategy on epidemic trend of iodine deficiency disorders (IDD) in Shanxi Province after universal salt iodization (USI),and to provide basis for timely adopting targeted control countermeasure and scientifically adjusting intervention strategy.Methods A method of retrospective analysis was performed to collect data from IDD surveillance at national or province levels after 1995,and from iodized salt surveillance of the province after 2004.According to the statistics and analysis of children's goiter rate,median urinary,median and mean of salt iodine,coverage rate of iodized salt,qualified rate of iodized salt,consumption rate of qualified iodized salt and their relationship.Results Since 1995,the children's goiter rate by palpation and B-ultrasound showed a steady descending trend.The median salt iodine,mean salt iodine and children's median urinary iodine showed a trend of rise→decline→stable→decline.Namely:The three indicators began to rise year by year from 1995 (29.1 mg/kg,31.7 ± 15.0 mg/kg,199.3 μg/L),in 1999 (48.7 mg/kg,53.4 ± 29.4 mg/kg,407.5 μg/L) reached its climax; and then decreased,in 2001 (34.7 mg/kg,36.2 ± 11.9 mg/kg,282.1 μg/L)stoped; which were basically stable from 2001 to 2011; since 2013 (26.0 mg/kg,26.5 ± 6.3 mg/kg,192.0 μg/L),a significant decline began.The rate and edible rate of qualified iodized salt showed a trend of decline→rise→stable.Two indexes began to decline circuitously from 1995 (72.61％,68.25％),and dipped to a low point in 1999 (44.80％,43.67％); then began to rise,until 2002 (94.73％,91.80％) reached basic stability; and remained steady from 2002 to 2013.Conclusions Following the process of prevention and treatment of IDD for more than 30 years in Shanxi Province,with the depth understanding of the range of adequate iodine nutrition,according to the monitoringfeedback mechanism,the strategy of salt iodization has been adjusted several times,the target of continuous elimination of IDD has achieved since 2000 and the levels of iodine nutrition in population are more reasonable.Salt iodization strategy should continue to adhere to.

Aim To explore the effect of knockdown spinal cord LCN2 by RNAi on the development of mor-phine tolerance in normal rats.Methods After suc-cessful intrathecal implantation, fourty-eight male Sprague-Dawley rats weighing 1 80 -220 grams were randomly divided into 4 groups (n =1 2):group I:control group,group II:morphine tolerance group, group Ⅲ:mismatch siRNA group,group IV:LCN2 siRNA group.The sixth day after intrathecal implanta-tion,rats were tested to ensure the position of cathe-ters,and it was recorded as d 0.On d 2 -8,rats were subcutaneously (s.c)injected of normal saline (NS) (group I)or morphine (group Ⅱ,Ⅲ,Ⅳ)1 0 μg· g -1 twice a day at 8:00 and 1 6:00.Before everyday s. c injection,rats were intrathecally injected of 1 0 μL DEPC solution (group Ⅰ,Ⅱ),1 0 μL DEPC solution containing 4 μg mismatch siRNA (group III)and 4 μg LCN2 siRNA solution (group IV).Paw withdrawal la-tencies to thermal stimuli (PWTL)were tested before morphine injection and 45 minutes after morphine in-jection on d 1 and d 9.The percentage of maximal pos-sible effect (% MPE)was calculated later.Animals were sacrificed on d 9 after the behavioral test and the lumbar enlargement segments of the spinal cord were removed for detecting the expression of phosphorylated-p38 mitogen-activated protein kinase (p-p38 MAPK) and LCN2 by Western blot and microglia marker Iba1 by immunofluorecence.Results On d 1 ,there was no significant difference in %MPE among four groups. On d 9,compared to group Ⅰ,%MPE was signifi-cantly reduced (P <0.05)while p-p38MAPK,LCN2 and Iba1 were markedly up-regulated in group Ⅱ andⅢ (P <0.05 ).On d 9,compared to group Ⅱ,%MPE was significantly increased while p-p38MAPK, LCN2 and Iba1 were markedly reduced in group IV (P<0.05).Conclusion Using LCN2 siRNA to knock-down spinal LCN2 relieves the development of mor-phine tolerance in normal rats possibly through inhibi-ting the activation of microglia and p38 MAPK in the spinal cord.

Objective To investigate the reproducibility and consistency in contouring parotid gland volume based on computed tomography (CT) and magnetic resonance (MR) images in patients with nasopharyngeal carcinoma during radiotherapy.Methods Twenty-seven patients with nasopharyngeal cancer in Shandong Cancer Hospital from December 2012 to May 2013 were randomly enrolled and underwent intensified CT and MR imaging before radiotherapy.The parotid gland were contoured with unified standard on both CT and T1-MR images by 11 radiotherapists.Specifically,one radiotherapist sketched the parotid gland on CT and MR images for ten times as intra-group comparison,the other ten were asked to sketch the parotid gland on CT and MR images only once as inter-group comparison.The intra-and inter-group's variations of parotid gland volumes were analysed.Results The average volumes of intra-group on CT and MR images were (33.8 ±9.4) cm3(L),(33.2±7.6) cm3(R) and (24.4 ±7.6) cm3(L),(22.5 ±7.4) cm3(R).As well,for inter-group the average volumes were (34.6 ± 12.1) cm3 (L),(34.3 ± 9.0) cm3 (R) and (24.6 ± 7.6) cm3 (L),(23.2 ± 8.1) cm3(R),respectively.The volume variable ratios on CT images were (6.8 ± 1.5)％ (L),(6.3 ± 1.5) ％ (R) for intra-group and (18.0 ± 4.8) ％ (L),(17.4 ± 4.6) ％ (R) for inter-group.Similarly,the intra-and inter-group ratios for contouring on MR images reached (2.3 ±0.4)％ (L),(2.1 ±0.7)％ (R) and (4.7 ±0.7)％ (L),(5.0±0.6)％ (R),respectively.Conclusion Parotid gland contouring based on MR images has a better reproducibility and consistency than that based on CT images.It is beneficial to get a more objective and true indicator to estimate the radiation injury of parotid gland.